[1Plus2]

Hello, all!

My local LLL group has been given a wonderful opportunity to educate a practice of doctors in our area on the benefits of bf'ing! There is a local practice who has interns come in every year and every year our LLL group is asked to speak to the interns about the benefits of bf'ing and how to speak to patients about bf'ing. This year, my Leaders have asked me to be present and to bring the girls with me to show that twins can be bf'd. What an incredible opportunity to educate the medical community...even if it is only a few doctors.

I was hoping that you all could help me with my project. I'm not being asked to speak (although I have a feeling I'll be asked plenty of questions on the subject) but I did want to type up a document to give to the doctors on what we as bf'ing mothers of multiples WISH the medical community knew.

Is there anything that a doctor told you that you wish they hadn't? Something you wish your doctor HAD told you or knew? What about bad information or advice passed onto you by your doctor? Please brainstorm and come up with some things that I can bring up. It doesn't have to be anything formal...just a few thoughts from each of you would be so wonderful!!!

It would be great if we posted them here so that we can maybe get a discussion started on the subject and bring up other points that way. Or, if you'd like, you can email me your ideas ([email protected]).

I'm so excited about this chance to possibly help a future patient of one of these doctors who is wanting to nurse her twins (or more!)!!!

 

[Amandzia]

This is a great opportunity. I'm so glad you are doing this!
I think it's important for doctors to have the basic info. on bfing and some handouts about it.
They need to know about supply and demand, that the more the baby is at the breast, the more milk there will be.
They need to be able to explain proper latch on to prevent sore nipples and to be sure baby is taking enough milk.
They should know about your local LLL group to tell moms interested in bfing.
They should have the latest info on nutritional and immunilogical benifits and also some info on jaundice in the bfing newborn.
They should be familiar with the World Health Org.'s recommendations about breastfeeding, durration of breastfeeding, and introduction of solids.
I think those would be the basics, but being doctors, I'd wish they knew even more.
Also, just a little reminder, they'll be more open to learning about breastfeeding if you all approach them respectfully. Doctors take pride in their knowledge (and rightfully so) and could be turned off if you are all too preachy. But you already know that as well as I, but I know I become a know-it-all at times and I need to be reminded not to offend people at times.
Good luck, and thank you to you and your LLL leaders and group.
~Amanda

 

[Piglet68]

What a fabulous opportunity!! While I don't have twins, I think many people are surprised that you can make enough milk for twins, given that so many people in our society think "lack of sufficient milk" is as common as hay fever!

: So I think it would be especially important for doctors to know that it is possible to nurse twins, due to the great supply and demand system of the breasts. Please tell us how it goes, okay??

 

[Quirky]

They need to learn about it, period. Doctors don't study lactation in med school or in their residencies. I'm all for respecting doctors for what they do know, but I think so many of them give advice on breastfeeding that's worse than useless when they don't know anything about it.

I think first and foremost they should be told (gently, but firmly) that if a woman comes to them with questions and concerns, they should help her IF they have researched or been taught the answers from a reputable source, but they should acknowledge the limits of their knowledge and send her on to an expert (an IBCLC or an LLL leader) if they can't help her. Give them the link to www.iblce.org so that they can see a) what it takes to become board certified and b)how to find an IBCLC near them.

They need to know that many medications are compatible with breastfeeding, and that they should neither prescribe nor refuse to prescribe a drug to a breastfeeding mom before looking it up in Hale's or the AAP list of approved drugs. Give them this link:

http://www.kellymom.com/meds/index.html

They need to know about thrush/yeast, and that both partners in the breastfeeding relationship need to be treated for it. I don't think doctors take yeast seriously enough by a long shot.

Above all, they need to know about the medical risks of formula feeding. Breastfeeding is not better than formula feeding - it's biologically normal, and formula feeding is unnatural and unsafe. They really need to have an attitude adjustment on this one (along with the rest of society). Give them this link - all medical studies done mostly in affluent societies on the risks of artificial feeding:

http://www.kellymom.com/newman/risks...ula_08-02.html

That's what I think is a bare minimum for them to know. Not to be all angry and militant sounding....well, actually, I am angry and militant about the appalling lack of breastfeeding knowledge among doctors in this country!

 

[Periwinkle]

I was thinking more along the lines of how to handle the issue of prematurity, which is much more common in multiple pregnancies. The common assumption is that you can't breastfeed or that it's a given you'll supplement with formula.

* How to start lactation by pumping.
* How to increase milk supply when pumping.
* How to integrate BFing and pumping, once they babies can get on the breast (i.e., there you are trying to BF but the babies aren't big enough to get all their milk from you, plus you have to pump to feed them EBM and/or to keep up supply)
* How to nurse preemies. (Positions, etc.)
* Common problems faced by preemies (poor latch, near comotose state / sleepiness, weak suck, plus common issues such as oral aversions, etc.)
OK so this one may be "controversial" for a LLL meeting, but an understanding of what kind of bottles/nipples to use for preemies with any of these above issue(s) AND who is trying to breastfeed (eventually).

 

[mom3]

I wish more doctors knew how important their attitude about breastfeeding is when speaking with a new mother. Most docs seem to assume the mother will fail in her attempt and give off that kind of energy from the start, often dooming the nursing relationship. Their optomistic, supportive, encouraging demeanor and words could do more for a new mother than any medical facts they could recite.

 

[Amandzia]

I've been talking to various moms who've had thrush and it seems many doctors aren't well informed about it's treatment. The OBs will treat the mom but not the baby and Pediatritions will treat the baby and not the mom. Mom doesn't often show simptoms but she feels much pain and the doctor doesn' t understand.
So, doctors, or at least their patience, need to know that to treat thrush (basically it's a yeast infection in the milk ducts) the baby and mom must both be treated or they'll keep passing it back and forth.

 

[kama'aina mama]

Quote:

Originally posted by TwinMommy OK so this one may be "controversial" for a LLL meeting, but an understanding of what kind of bottles/nipples to use for preemies with any of these above issue(s) AND who is trying to breastfeed (eventually).

I think this is an EXCELLENT point and LLL should not shy away from it. If a mom needs to supplement or use bottles of her own milk for any reason LLL should be helping her figure how to feed baby while minimizing the likelyhood of nipple confusion. That may mean nipple research, it may mean SNS or a cup or fingertip syringe... I don't know, but I sure hope LLL doesn't draw a line in the sand about "if it's not straight from breast to baby we can't help you."

 

[Amandzia]

Nothing I've read in LLL literature or from the leaders that leads me to believe that LLL is against bottles altogether. They do say that some babies can become nipple confused in the first 3 or 4 weeks, so if possible, use another way to give the baby milk until breastfeeding has been established. They also say that a baby nursing from the breast is the most effective way of establishing a good milk supply because a baby is better at getting milk from a breast than a pump or hand expression. That's just stuff that has been found in research. They aren't opposed to bottles if they are needed. They just want us to reach our breastfeeding goals and are available with information.

 

[Amandzia]

Nothing I've read in LLL literature or from the leaders that leads me to believe that LLL is against bottles altogether. They do say that some babies can become nipple confused in the first 3 or 4 weeks, so if possible, use another way to give the baby milk until breastfeeding has been established. They also say that a baby nursing from the breast is the most effective way of establishing a good milk supply because a baby is better at getting milk from a breast than a pump or hand expression. That's just stuff that has been found in research. They aren't opposed to bottles if they are needed. They just want us to reach our breastfeeding goals and are available with information.

 

[Periwinkle]

Quote:

Nothing I've read in LLL literature or from the leaders that leads me to believe that LLL is against bottles altogether.

Right, but their acceptance of bottle feeding (which is up for debate) is not what I took issue with. My LLL Mothering Multiples book is probably my favorite all-time baby resource book, and I've used it to help me through many a challenge successfully.

But what I definitely did NOT find in the book, that I would have killed for, is a detailed explanation about what exactly is the difference between all those nipples, bottles, nipple holes, nipple flows, bottle systems, etc., etc., especially as it relates to feeding preemies (or even babies with health issues) who you are trying to hopefully one day nurse exclusively. I probably spent $80 and a very stressful week or more before landing on the right combo for my little guys, back when I was pumping but before they were able to nurse exclusively yet.

The funny thing was, my LC (who I got in touch with as I was nearing the end of my rope, caused by, among other things, a total inability to find a bottle dd and ds would accept other than the disposable ones they used in the NICU) had a definite opinion on the matter.

Just made me think that I could probably write an entire chapter myself on which bottles I hated, which nipples worked best for reflux, which ones worked best for lazy suck, which worked best for overactive gag reflex, and so on! Of course there will always be some trial and error, but, for example, I can tell ya not to use the Avent #2 nipples I had lying around from my baby shower on a 36 weeker.

:LOL

So while I agree that LLL doesn't come out as being flat out against bottle feeding, they don't exactly go into a lot of detail about it either, and leave a lot of guesswork up to us, where good information could help at least point us in the right direction. Oridinarily, I'd think that was a good thing, not yammering on about bottles, because LLL after all is striving for the admirable goal of breastfeeding, the way nature intended. But my post was specifically about preemies, and as such, bottle feeding's gonna happen at some point, period -- it would just be nice if there were better info out there on bottle feeding for those of us who had no choice but are working toward the goal of breastfeeding.

 

[1Plus2]

Hi, all! I wanted to thank everyone for their input on this thread. We had the presentation this past Friday and it went REALLY well! There were 3 LLL Leaders presenting information and about 12-15 doctors. They were all very inquisitive and receptive to the entire presentation. I was there with my 3-year-old and twins and they did ask me some questions. I was also asked to demonstrate tandem nursing twins!! That was interesting to say the least. Anyway...just wanted to say thanks and to let you all know how it went.